India should set up strong surveillance system over salt intake

We strongly recommend against a drastic reduction in sodium intake to <3 g/day until evidence is available from large clinical trials that show clear benefits, said an editorial in The National Medical Journal of India.

“The foremost priority in India at present should be to set up a strong surveillance system to provide the basis for policy formulation and implementation, and to adhere to the WHO 2025 target of 30% reduction in salt intake.

“There is an urgent need to develop strategies for the reduction in salt consumption among individuals who suffer from hypertension,” it said. The editorial “Salt Reduction at a Population Level: To do or not to do?” said that while stressing the need for further research and more robust evidence to recommend a population-level policy, we agree on the current WHO monitoring framework target of a 30% reduction in sodium intake for Indian settings that are presently presumed to have high salt consumption.

Scientists have often debated whether to consider salt as an essential nutrient with recommended dietary intake or a toxin with a maximum tolerated dose. The recommended daily intake of a nutrient is calculated using the approximate intake found in the apparently healthy population.

While some would argue that salt is a nutrient and should be no exception to this norm, others hold the opinion that the present average consumption itself is higher than that required by the human body. According to these values only 2.5% of the world’s population meets the current recommended salt intake.

A recent meta-analysis done by the Global Burden of Diseases, Nutrition and Chronic Diseases Expert Group (NutriCoDE) has shown that the average global consumption of sodium is 3.95 g/day. They concluded that this was more than twice the current recommended sodium consumption of <2 g/day, and added that almost all countries had values higher than the recommended level.

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